Description: Diabetes mellitus type 2 is an excellent model for assessing the setup of medical coverage in the U.S. health care system. It is a chronic disease that has genetic, behavioral and other medical causes, and causes many complications over the long term. From Financing Chronic Care Monograph, M-HB05-1.

Description: Provides an overview of developments in the healthcare market including provider billing practices. Provides an overview of the Government Finance Officer’s Association (GFOA) in New York on Dec. 6, 2018

Description: This 1978 session focused on regulatory considerations in Group Health Insurance focused on the following questions: 1. What is the impact of National Health Insurance and Federal Hospital Cost Control? 2. What is the impact of non-discrimination legislation and regulation? 3. What is the impact of recent OASDI financing changes and changes in mandatory retirement age? 4. What is the future of multi-employer trusts and self-insurance?

Description: Through a case study, this session at the 2004 Valuation Actuary Symposium explores the issues e.g., grouping, expenses, time period, etc. involved in determining deficiencies reserves for health products. Accounting guidance and standard industry procedures are discussed.

Description: This paper explores the legislation of New York 65, the intent of which was to offer health benefits to persons age 65 and over without health examination or other evidence of insurability. From TRANSACTIONS OF SOCIETY OF ACTUARIES, 1962 VOL. 14, PT. 1 NO. 40.

Description: This session at a SOA 1990 Spring Meeting is about open ended managed care plans from various perspectives including structure, marketing and actuarial issues.

Description: Under the Affordable Care Act (ACA), groups with 50 or less full time employee equivalents will eventually be subject to the ACA’s modified community rating rules. While some groups will see lower premiums than they would have without the ACA, others will see significant premium increases. Many of the latter type opted for transitional relief beginning in 2014 to avoid the ACA as long as possible. With the end of transitional relief approaching in 2018, what will these groups do? One option will be to self-insure using a product generically termed Level Funding.

Description: This discussion at the San Francisco and Washington 1966 Regional Meetings covers three topics - Disability Benefits under Life or Health Insurance Policies, Changes in Individual Medical Expense Insurance in the Light of Medicare, and Optional Modes of Settlement.

Description: This paper explores the legislation of Mass 65, the intent of which was to offer health benefits to persons aged 65 and older without evidence of insurability. From TRANSACTIONS OF SOCIETY OF ACTUARIES, 1962 VOL. 14 PT. 1, NO. 40.

Description: This chapter focuses on creating practical models that aid in the prediction of the risk of readmission to a specific hospital within 30 days of discharge for Medicare patients, to aid in the identification and stratification of at-risk patients for hospitals considering building an intervention program in a cost-effective manner. For readers who wish to develop their own predictive model, a dataset is provided on the Actexmadriver.com website, and R code is provided in the appendix to this chapter.